How much rates vary
Facilitymedian $1,318 · 10th to 90th $407 to $3,548Professionalmedian $1,905 · 10th to 90th $1,096 to $7,762
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $2,691.53 Median $3,090.30 Typical High $5,128.61 | Facility | None | $2,691.53 | $3,090.30 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $3,715.35 | Professional | None | $812.83 | $812.83 | $3,715.35 |
AllWays Health Partners Setting Facility Modifier None Typical Low $346.74 Median $851.14 Typical High $3,548.13 | Facility | None | $346.74 | $851.14 | $3,548.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $1,122.02 Median $2,818.38 Typical High $7,762.47 | Professional | None | $1,122.02 | $2,818.38 | $7,762.47 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $954.99 Typical High $1,380.38 | Facility | None | $50.12 | $954.99 | $1,380.38 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $1,737.80 Typical High $3,162.28 | Professional | None | $1,737.80 | $1,737.80 | $3,162.28 |
Fallon Health Setting Facility Modifier None Typical Low $1,174.90 Median $1,445.44 Typical High $3,311.31 | Facility | None | $1,174.90 | $1,445.44 | $3,311.31 |
Fallon Health Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $1,737.80 | Professional | None | $1,230.27 | $1,445.44 | $1,737.80 |
Harvard Pilgrim Setting Facility Modifier None Typical Low $295.12 Median $954.99 Typical High $4,073.80 | Facility | None | $295.12 | $954.99 | $4,073.80 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $1,318.26 Median $2,398.83 Typical High $3,630.78 | Professional | None | $1,318.26 | $2,398.83 | $3,630.78 |
Mass General Brigham Setting Facility Modifier None Typical Low $346.74 Median $851.14 Typical High $3,548.13 | Facility | None | $346.74 | $851.14 | $3,548.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $1,122.02 Median $2,818.38 Typical High $7,762.47 | Professional | None | $1,122.02 | $2,818.38 | $7,762.47 |
United Setting Facility Modifier None Typical Low $295.12 Median $1,023.29 Typical High $4,073.80 | Facility | None | $295.12 | $1,023.29 | $4,073.80 |
United Setting Professional Modifier None Typical Low $1,412.54 Median $1,995.26 Typical High $5,495.41 | Professional | None | $1,412.54 | $1,995.26 | $5,495.41 |
Well Sense Setting Facility Modifier None Typical Low $912.01 Median $1,258.93 Typical High $1,862.09 | Facility | None | $912.01 | $1,258.93 | $1,862.09 |
Well Sense Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,148.15 | Professional | None | $954.99 | $954.99 | $1,148.15 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $407.38 Median $407.38 Typical High $1,819.70 | Professional | 52 · Reduced service | $407.38 | $407.38 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $741.31 | Professional | 53 · Discontinued | $165.96 | $165.96 | $741.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $616.60 Median $616.60 Typical High $2,754.23 | Professional | 54 · Surgery only | $616.60 | $616.60 | $2,754.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $123.03 Median $123.03 Typical High $549.54 | Professional | 55 · Aftercare only | $123.03 | $123.03 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $81.28 Median $81.28 Typical High $371.54 | Professional | 56 · Pre-op care only | $81.28 | $81.28 | $371.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $575.44 Median $575.44 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $575.44 | $575.44 | $2,570.40 |
Where Massachusetts sits
The same service costs 6.4 times more in Alaska than in Maryland. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Physician feeFacility fee
AK $12,091MD $1,881
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.